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The cortical projection of the thalamic mediodorsal nuclear complex (MD) in the rabbit was mapped retrograde horseradish peroxidase and anterograde tritiated proline techniques. The projection field occupied the entire medial wall rostral to a mid corpus callosal level, wrapped around the frontal pole onto the lateral convexity and tailed off caudally on the dorsal bank of the rhinal sulcus. The projection of the lateral approximately one-half of MD, the half which does not receive olfactory input, was confined to medial cortex supply all but the most rostral region. This projection field of lateral MD was precisely organized in two dimensions with the most lateral part projecting most caudally and the most dorsal part projecting most ventrally. A representation for the third, anterior-posterior (A-P), dimension was not evident since any cortical point within the field was supplied by a cylinder of cells extending the entire A-P extent of lateral MD. The medial half of MD, which does receive olfactory input, projected to the remaining rostral medical cortex, the lateral convexity and rhinal sulcal region. The inverse dorsoventral relationship was partially preserved and on overlapping A-P gradient was present with sulcal projections originating more caudally in medial MD and the rostral medial projection originating more rostrally.

A 3,400-g female neonate with a large head, widened sutures, and full fontanels at the time of her delivery by cesarean section is described. Imaging with ultrasound and computed tomography at 24 and 36 hours of age showed findings typical of hydrocephalus caused by intraventricular hemorrhage occurring several days or more prior to birth. There was no direct evidence of any predisposing vascular lesion or coagulopathy. Such a phenomenon has not been previously reported.

In view of the reported immunomodulatory properties of the monoaminergic neurotransmitter, serotonin (5HT), this study aimed to assess whether 5HT specifically associates with immunocompetent cells. Although murine splenocytes appear to lack high-affinity membrane binding sites for 5HT, they do possess a specific, active, 5HT uptake system similar in affinity (Km = 40 nM) to that described in platelets. This uptake system appears to be confined to macrophages. Further, macrophages rapidly metabolize 5HT to its 5-hydroxyindole acetic acid metabolite. Specific uptake of serotonin by macrophages may thus constitute an important mechanism whereby this amine is able to regulate immune function.

We report an infant of a diabetic mother (IDM) with in utero brachial artery thrombosis and neonatal gangrene to illustrate that there may be an increased risk for arterial as well as venous thrombosis in IDMs. The diagnosis of brachial artery thrombosis was made by using Doppler sonography flow studies and was confirmed with autopsy. The postnatal period was complicated by aortic and mesenteric artery thrombosis, with subsequent necrotizing enterocolitis, renal infarction, and death. Gangrene of a limb presenting at birth is rare, with 32 individuals reported in the literature, including this patient. Twenty-two percent (7/32) of the infants with peripartum limb gangrene were IDMs. This implies a marked increase in arterial thrombosis in IDMs over the general population. Changes in coagulation factors have been reported in newborn IDMs with poor control of maternal diabetes. Increased clotting and decreased fibrinolysis found in diabetics may lead to arterial thrombosis in IDMs in utero and postnatally. Use of anticoagulants in at-risk infants should be considered to prevent further thrombosis postnatally. Additionally, IDMs may be at increased risk for thrombotic complications from umbilical artery catheter. In utero thrombosis of the brachial artery may be one mechanism which leads to limb reduction defects in IDMs.

Retinopathy of prematurity is a retinal vascular disease that occurs only in premature infants. Because of concern that the occurrence of this potentially blinding disease is increasing, a retrospective chart review was undertaken to compare the incidence of retinopathy of prematurity at the University of Washington during the years 1981 to 1984 with previously published data collected at the same institution during the years 1968 to 1980. During 1981 to 1984, there was an increase in the annual numbers of admissions and survivors weighing 1750 g at birth; the survival rate increased significantly (P less than .000001). A trend toward an increased risk for proliferative retinopathy of prematurity (P = .057) during 1981 to 1984 period was noted, but the number of "excess cases" was calculated to be only 6 per year. The remainder of the additional cases, 19 annually, were due to increased survival of infants at risk. Thus, the "second epidemic" of retinopathy of prematurity is largely due to improved survival of low birth weight infants rather than to new iatrogenic factors. In infants with proliferative retinopathy of prematurity, there was a previously unreported association between increased severity of disease and lower birth weight (P = .015). There were four children with severe bilateral visual loss due to retinopathy of prematurity identified during the 1981 to 1984 period, whereas only one bilaterally blind infant was noted during the preceding 12.7 years.